Agenda and minutes

·         CQC Inspection of Children’s Community Services

·         Signing of the Carers Memorandum of Understanding

The Chair drew the meeting’s attention to the announcements in the agenda pack as follows:

·       CQC Inspection of Children’s Community Services

·       Signing of the Carers Memorandum of Understanding

As it was the Vice-Chair Dr Jenkins’ last meeting, the Chair took the opportunity to thank him for his hard work on the Board and for his efforts in cementing the relationship between the CCG and Wiltshire Council.

It was noted that Dr Richard Sandford-Hill would be he chair of CCG and would then become vice-chair of the Health and Wellbeing Board.

Apologies were received from:

·       Nerissa Vaughan

·       Dr Tony Sutcliffe from AWP who will no longer be attending and will be replaced by Dr Bill-Bruce Jones for future meetings; and

·       Dr Andy Smith - SWAST

To confirm the minutes of the meeting held on 13 July 2017.

The minutes of the previous meeting were considered.

Resolved

To approve for signing the minutes of the previous meeting held on 13 July 2017

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of interest.

The Council welcomes contributions from members of the public.

Statements

If you would like to make a statement at this meeting on any item on this agenda, please register to do so at least 10 minutes prior to the meeting. Up to 3 speakers are permitted to speak for up to 3 minutes each on any agenda item. Please contact the officer named on the front of the agenda for any further clarification.

Questions

To receive any questions from members of the public or members of the Council received in accordance with the constitution.

Those wishing to ask questions are required to give notice of any such questions in writing to the officer named on the front of this agenda no later than 5pm on Thursday 14 September 2017 in order to be guaranteed of a written response. In order to receive a verbal response questions must be submitted no later than 5pm on Friday 15 September 2017. Please contact the officer named on the front of this agenda for further advice. Questions may be asked without notice if the Chairman decides that the matter is urgent.

Details of any questions received will be circulated to Committee members prior to the meeting and made available at the meeting and on the Council’s website.

There were no questions or submissions.

To receive an update on the delivery of the Better Care Plan for Wiltshire; and how the commissioning intentions as approved are being delivered in the context of the latest national planning requirements, including delayed transfers of care trajectories.

Responsible Officers: Carolyn Godfrey, Linda Prosser

Report author: Sue Shelbourn-Barrow

Sue Shelbourn-Barrow, the newly appointed Integration Manager, gave an update on the delivery of the Better Care Plan for Wiltshire.

Matters highlighted in the course of the presentation and discussion included: the matters previously reported to the project board; the future challenges to be faced in the winter; how resources are allocated efficiently; what flexibility there is in the programme; that all projects in programme will be evaluated to enable decisions to be made to stop some programmes and reinvest in others.

Recommendation:

To note the progress and the next steps

An update on the delivery of the Adult Social Care Transformation.

Responsible Officers: Carolyn Godfrey

Report author: Alison Elliott

Alison Elliot, Wiltshire Council, give an update on the Adult Social Care

programme and reported progress to date.

Matters highlighted in the course of the presentation and discussion included: the focus on delayed transfers of care; the partnership working that had allowed for the development of the programmes; how the programme interacts and is part of the Better Care Fund; that measuring of outcomes is crucial, and how the  performance framework is being developed; how to ensure sustainable funding; the concerns over the impact of the winter flu season; that further reports could be made to the board.

Resolved

To note the progress to date

To outline the implementation plan for the end of life care strategy, with input and discussion from local hospices. An update on the implementation plan for children will be provided at the next meeting.  

Responsible Officers: Carolyn Godfrey, Linda Prosser

Report author: Kate Blackburn, Ted Wilson, Gail Warnes

Ted Wilson, Wiltshire CCG, and Kate Blackburn, Wiltshire Council, presented the outline of the implementation plan for the end of life care strategy, with input and discussion from local hospices representatives, Wayne de Leeuw, Executive Clinical Lead of Dorothy House Hospice and Angela Jordon, Chief Executive of Prospect Hospice.

Matters highlighted in the course of the presentation and discussion included:

how information is shared to improved services; how the users and families are involved; how the hospice users have been involved in the development of the strategy; how efforts are made to allow people to die at home in accordance with their wishes; how getting people out of acute settings and into the home has approved; how do stop end of life patients from entering hospitals and the recognition that further work is needed; the need to make carers more aware that treatment escalation plans (TEP) are in place and that the wishes of patients not to transfer to acute providers; that some evidence shows that care homes are still ringing 999 even though there is a (TEP); using ICT and communications better allowing Ambulance better access; the work undertaken by Health Watch Wiltshire; and an update on the implementation plan for children would be provided at a future meeting.

Resolved

To approve the Implementation Plan

A presentation on the results of the recent school health and lifestyle survey for Wiltshire and update on the ongoing work on healthy schools.

Responsible Officers: Carolyn Godfrey

Report author: Sarah Heathcote, Nick Bolton

Sarah Heathcote, Wiltshire Council presented an update on the five year programme.

Matters highlighted in the course of the presentation and discussion included:  how data can help schools plan their interventions; that the survey had a high response rate; how the data can be explored for different groups such as looked after children; how older children (+16) are making bad food choices and are doing less exercise – and that inactivity with children is more acute; that peer influencing can be more effective; the importance of sleep and the impact of worry and anxiety; the importance of emotional wellbeing; the training that can be done to improve skills for teachers; that vulnerable children are more at risk to bullying; the areas that children would like more support including – improving fitness, and managing money; how thematic reports will be developed and that further work will be done with colleagues to look at data in depth; how area boards can be used to promote the programme amongst schools in their communities; and the links to the work undertaken by Health Watch Wiltshire.

Resolved

1.    To note the work of the Wiltshire Healthy Schools programme; and

2.    To agree to support the work of the Wilshire Healthy Schools programme.

To receive an update on the delivery of the local Workforce Strategy.

Report author: Jenny Hair

Jenny Hair, Workforce Lead for the Better Care Plan, gave a summary of the workforce challenges within the adult health and social care system and the transformation required in order to achieve delivery of operational plans; and an update on the actions that have been taken in the last year to help address the challenges and plans for the future.

Matters highlighted in the course of the presentation and discussion included:  that locally and nationally the pool of talent is small; how Wiltshire is marketing itself better; the changes to education and training; that long-term strategies are required; that some work is focused on the Sustainable Transformation Plan area and some on just Wiltshire; the liaison with the Council’s economic development departments; how to encourage students to undertake placements and then stay longer; the opportunities to improve the skills of carers; how staff can be trained to encourage users to take greater responsibility of their care; how to better engage partners including voluntary sector; some concern that not enough progress was being made; what help could be sought from the Local Enterprise Partnership and the colleges;  and the work to improve career and training pathways for carers.

Following the conclusion of the discussion, the meeting;

Resolved

1.    To note the update;

2.    To request that officers draft a letter to the Local Enterprise Partnership highlighting the need for a discussion workforce issues in the health and social care sector, and emphasising that the sector is one of the biggest employers and crucial to economic wellbeing of the County.

To receive updates on the commissioning of support services related to:

a)    domestic abuse; and

b)    substance misuse.  

Responsible Officers: Carolyn Godfrey, CAO

Report author: Tracy Daszkiewicz and Kate Blackburn

Tracy Daszkiewicz, Wiltshire Council,  presented: an updated overview of the domestic abuse reduction agenda in Wiltshire; and an overview of the substance misuse agenda in Wiltshire, in particular updating on the pan Wiltshire tendering process.

Matters highlighted in the course of the presentation and discussion included: the local priorities for action; how housing and safeguarding of children are included in the procurement service specification; how the needs assessment and information has refocused, with regard to substance misuse, work on prevention and support services; the work with mental health colleagues to do joint diagnosis;  

Resolved

1.    To note the reports

2.    To request further update 6-9 months after the contracts are operational.

To approve the Pharmaceutical Needs Assessment for consultation. 

Responsible Officers: Tracy Daszkiewicz

Report author: Steve Maddern

Steve Maddern, Wiltshire Counci, presented the draft Wiltshire Pharmaceutical Needs Assessment (PNA).

Matters highlighted in the course of the presentation and discussion included: the timeline for developing and agreeing the PNA; that the PNA steering group includes a range of partners including Healthwatch Wiltshire; that the purpose of the document is to support NHS England to plan pharmaceutical services; that the coverage is adequate compared to national standards; how carers and the general population had been engaged with; how the impact of the army rebasing is taken into account; how availability of deliveries and use of the internet has expanded.

The Chairman commended the officer for the quality of the report, and noted that it would return to the Board in the new year for final agreement.

Resolved

1.    To approve the Wiltshire Pharmaceutical Needs Assessment 2018 for 60 days public consultation in line with the regulations; and

2.    To delegate responsibility for responding to cross-border Pharmaceutical Needs Assessment consultations to the public health led responsible for the Pharmaceutical Needs Assessment on behalf of the Health and Wellbeing Board.

To receive the annual report of the Wiltshire Safeguarding Children Board for 2016/17. 

Responsible Officers: Mark Gurney, Independent Chair

Mark Gurrey presented the annual report of the Wiltshire Safeguarding Children Board.

Matters highlighted in the course of the presentation and discussion included: that this was the end of the first full year as chair; the changes in the board structure and the cooperation from partners on the work of the board; that the membership and work of the meeting had been streamlined to ensure that the focus of the board is better; how the voice off young people and practitioners are brought to the board; the ongoing work addressing issues around child sexual abuse; that Wiltshire was part of a joint targeted area assessment, and how this information was pulled together in a national report on the impact of domestic abuse on children; the areas for future work of the board, including issues of neglect;  and how meeting the needs of families can improve outcomes for children.

In response from a question from the Chairman Baroness Scott. Mr Gurrey stated that there was some more work to be done to raise the awareness amongst partner agencies of the signs of Child Sexual Abuse so that they are better able to identify children at risk.

In response from a question from the Dr Richard Sandford-Hill, Mr Gurrey stated that there was good communication between strategic partners no the board, but that there were still improvements to be made regarding communication and information sharing amongst the frontline staff.

In response from a question from the Dr Peter Jenkins, Mr Gurrey stated that engagement with GPs had improved.

Following the conclusion of the discussion, the meeting;

Resolved

i)       To note the publication of the Wiltshire Safeguarding Children Board Annual Report; and

ii)      To agree to continue to support the work of the Wiltshire Safeguarding Children Board and to effectively co-ordinate the work we are doing across partnership arrangements.

To provide an update on the Strategic Outline Case (SOC) for Chippenham, Melksham and Trowbridge. Ahead of an update paper to be provided, a link to the paper considered by the CCG in July is included below.

http://www.wiltshireccg.nhs.uk/wp-content/uploads/2013/03/Paper-10-Strategic-Outline-Case.pdf

Linda Prosser

Interim Accountable Officer

Wiltshire CCG

Linda Prosser, Wiltshire CCG, presented an update on the Strategic Outline Case (SOC) for Chippenham, Melksham and Trowbridge.

Matters highlighted in the course of the presentation and discussion included: that the process signals the intention of the CCG to address the capital and estate requirements for those areas; that a paper will be taken to the CCG board to look at whole county; that there will be 30% growth in population in those areas; that there had been some additional capital money available from central government for Trowbridge; that the outline business case will say what the hub and what the spoke will be; the links to the one public estate; and the importance of keeping the public well informed so that concerns can be addressed.

The Chair thanked the officers for the presentation.

The next meeting will be 9 November 2017.

It was noted that the date of the next meeting had changed and would now take place at 10am on Thursday 9 November 2017.

There were no urgent items.